Limited Power of Attorney Form
Introduction
This Limited Power of Attorney dated Month Day, Year, grants the Agent temporary authority to act on behalf of the Principal for specific matters. The authority is limited to the terms and time period specified and can be revoked by the Principal at any time.
Principal Information
Agent Information
Powers Granted
I hereby appoint the above-named Agent to act on my behalf in the following matters:
Duration of Authority
This Limited Power of Attorney shall be effective:
Revocation
This Limited Power of Attorney may be revoked at any time by the Principal by providing written notice to the Agent.
Signature
By signing below, I, the Principal, authorize the Agent to act on my behalf in the matters outlined, limited to the specified terms and time period.
| Principal 
 Name:  Date:  | Agent 
 Name:  Date:  | 
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